Zhuang Taifeng, Han Huijun, Yang Zhenyu
Department of Neonatal Intensive Care Unit (NICU), Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005, China.
Nutrients. 2014 Sep 25;6(9):3968-80. doi: 10.3390/nu6093968.
Both iron deficiency and hyperglycemia are highly prevalent globally for pregnant women. Iron supplementation is recommended during pregnancy to control iron deficiency. The purposes of the review are to assess the oxidative effects of iron supplementation and the potential relationship between iron nutrition and gestational diabetes. High doses of iron (~relative to 60 mg or more daily for adult humans) can induce lipid peroxidation in vitro and in animal studies. Pharmaceutical doses of iron supplements (e.g., 10× RDA or more for oral supplements or direct iron supplementation via injection or addition to the cell culture medium) for a short or long duration will induce DNA damage. Higher heme-iron intake or iron status measured by various biomarkers, especially serum ferritin, might contribute to greater risk of gestational diabetes, which may be mediated by iron oxidative stress though lipid oxidation and/or DNA damage. However, information is lacking about the effect of low dose iron supplementation (≤ 60 mg daily) on lipid peroxidation, DNA damage and gestational diabetes. Randomized trials of low-dose iron supplementation (≤ 60 mg daily) for pregnant women are warranted to test the relationship between iron oxidative stress and insulin resistance/gestational diabetes, especially for iron-replete women.
缺铁和高血糖在全球孕妇中都极为普遍。孕期建议补充铁剂以控制缺铁情况。本综述的目的是评估铁补充剂的氧化作用以及铁营养与妊娠期糖尿病之间的潜在关系。在体外实验和动物研究中，高剂量的铁（相对于成年人类每日60毫克或更多）可诱导脂质过氧化。短期或长期服用药物剂量的铁补充剂（例如，口服补充剂为推荐膳食摄入量的10倍或更多，或通过注射或添加到细胞培养基中直接补充铁）会导致DNA损伤。通过各种生物标志物（尤其是血清铁蛋白）测得的较高血红素铁摄入量或铁状态，可能会增加妊娠期糖尿病的风险，这可能是通过脂质氧化和/或DNA损伤介导的铁氧化应激所致。然而，关于低剂量铁补充剂（每日≤60毫克）对脂质过氧化、DNA损伤和妊娠期糖尿病的影响，目前尚缺乏相关信息。有必要对孕妇进行低剂量铁补充剂（每日≤60毫克）的随机试验，以检验铁氧化应激与胰岛素抵抗/妊娠期糖尿病之间的关系，特别是对于铁储备充足的女性。
